Methods : We analyzed cross-sectional survey data from 1,623 US caregivers with a food-allergic child collected between November 2011 and January 2012. We used a 2-part regression model to estimate mean costs and identified differences by levels of household income and race and ethnicity.
Results : Children in the lowest income stratum spend two and one half times the amount on emergency department and hospitalization costs as a result of their food allergy than either of the other two income strata ($1,021, SE ±$209 versus ($434, SE±$106, and $416, SE±$94, p<0.05). Spending on specialists visits were lower in the lowest income stratum ($228, SE ±$22) compared with the highest income stratum ($311, SE ±$18, p<0.01). ). In terms of adjusted mean out-of-pocket costs, we found that increasing family income was significantly associated with increasing out-of-pocket medication costs ($171 lowest income stratum, SE±$26; $366 highest income stratum, SE±$44, p<0.001). African-American caregivers reported spending the lowest amount on direct medical and out-of-pocket costs, with average adjusted costs of $493 (SE ±$111) and $395 (SE ±$429), respectively.
Conclusions: Socioeconomic disparities exist in the economic impact of food allergy. Opportunities exist to mandate that life-saving medications are available more widely and to strength policy related to the management of food allergy in public spaces such as schools, parks, and restaurants.